Expert: Claes-Gustaf Nordquist, M.D. - 3/20/2009

Question
QUESTION: Hello,
I have had many concusions in my past from horse and car accidents as a kid (20 years ago). The last 6 months I started having very bad headaches. My right eye starts to shake and is hard to focus with double fision. I have noticed it is hard to swallow alot of times. I feel dizzy and my head feals like I'm in a vise and it is squeezing me tighter.
I had an mri of my brain today and the radiologist called my Dr. and said I need to get in for a CT scan. He wants to look at my bones in an area. Do you have any idea of what this could mean. Would the MRI have shown a tumor???
Thank you much


ANSWER: There are actually many possibilities. Which of these it may be is unfortunately impossible to say. It may be a tumor but again it may be something else. That there is SOMETHING there is unfortunately pretty obvious both from the reaction of your radiologist and from your symptoms but more than that is impossible to say. However if this was just a case of a brain tumor I wonder why any CT scans would be necessary. In that case an MRI scan should be quite sufficient. The normal procedure in such cases is that a CT scan is done (often as an emergency action), something is seen there and THEN an MRI scan is done to better evaluate what that is! Here the opposite is done! CT scans are often somewhat better than MRI scans of the brain when it comes to bleedings. With your background - even if it was long ago - that MAY be a possibility. But this is just an "educated" guess. NOTHING more and actually outside my area of expertise here which is strictly tumors!
Good luck!


---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your responce. My Dr. Sent me over this morning to have a CT scan of my brain. This is what the MRI said from yesterdays test:
"heterogeneous marrow signal in the clivus on the sagittal T1 weighted sequences. This may represent a normal variant, but an osseous lesion is also in the differential. Recommend CT of the head for further evaluation."
Then today after my CT scan, they said it looked normal. Now I don't know what to believe. My Dr. said the Radiologist was worried about my Bones??
Does this make any sence at all. What kind of a specialist should I see if any?
Thank you so much for your time and kindness.
Tammy

Answer
Yes it does. Your MRI scan indicated that maybe there was a bone lesion in your skull (something MRI scans normally are not good at detecting) and therefore a CT scan (which is VERY GOOD at detecting such things) was ordered. The CT scan could NOT detect any such lesion and therefore it is quite certain that no such lesion exists! So in my opinion and as far as I can understand also in your dr.'s you can now forget the whole thing because nothing dangerous has been found! Good luck!